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Screening for osteopenia and osteoporosis: selection by body composition
K Michaëlsson1, R Bergström, H Mallmin
1Department of Orthopaedics, Central Hospital, Västerås, Sweden.
Summary
Simple weight measurements can identify women at low risk for osteoporosis, potentially excluding them from costly bone density screenings. Higher body weight is strongly associated with lower osteoporosis risk, making it a useful screening tool.
Area of Science:
- Orthopedics
- Radiology
- Gerontology
Background:
- Osteoporosis screening using bone mineral density (BMD) is expensive and time-consuming for the general population.
- There is a need for simple methods to identify individuals at low risk for osteoporosis, enabling exclusion from screening.
- Body composition and BMD are known to be related, but specific predictive relationships require further elucidation.
Purpose of the Study:
- To determine the relationship between various body measures and BMD in women.
- To assess the utility of body weight as a simple screening tool for identifying women at low risk of osteoporosis.
- To evaluate the potential for excluding women from BMD screening based on body weight criteria.
Main Methods:
- A cross-sectional study involving 175 women aged 28-74 years in central Sweden.
- Dual-energy X-ray absorptiometry (DXA) was used to measure BMD at the total body, lumbar spine (L2-L4), and femoral neck.
- Multiple linear regression and logistic regression models were employed to analyze the relationship between body measures (weight, height, BMI, lean mass, fat mass, WHR) and BMD, adjusting for confounding factors.
Main Results:
- Body weight alone explained a significant portion of the variance in BMD: 28% (total body), 21% (lumbar spine), and 15% (femoral neck).
- Women weighing over 71 kg had a significantly lower risk of osteopenia compared to those weighing under 64 kg (ORs ranging from 0.01 to 0.13).
- A weight threshold of over 70 kg indicated a low likelihood of osteoporosis, with a negative predictive value (NPV) of 0.97 for the femoral neck and 0.91 for the total body.
Conclusions:
- Body weight is a simple and effective measure for identifying women at low risk of osteoporosis, particularly postmenopausal women.
- Using a weight criterion (e.g., >70 kg) could allow for the exclusion of a significant proportion of women from BMD screening without missing a substantial number of osteoporosis cases.
- Weight could serve as a practical tool to optimize osteoporosis screening programs, reducing costs and time associated with widespread BMD testing.